NPIMap

Organization Active NPI

Central MN Pediatric Dentists, PA

  • Pediatric Dentistry
  • Brainerd, MN
National Provider Identifier
1174962674
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D11073 Issued in MN
Legal business name
CENTRAL MN PEDIATRIC DENTISTS, PA
Practice address
1903 S 6TH St
Brainerd, MN 56401-4599
Phone
(320) 253-0272
Fax
(320) 251-2661
NPI assigned
Jun 18, 2013
Last updated
Jun 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael W. Steil, DDSNPI 1629018536
Title
Partner/Owner
Phone
(320) 253-0272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X D7765 MN
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X D12885 MN
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X D11073 MN Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X D11344 MN

Addresses

Primary practice location

1903 S 6TH St
Brainerd, MN 56401-4599

Mailing address

1900 Centracare Cir
Suite 0350
Saint Cloud, MN 56303-5000
Phone (320) 253-0272

National Provider Directory

National Provider Directory
Tax ID family
Central Minnesota Pediatric Dentists PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1174962674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR",
            "address_2": "SUITE 0350",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-253-0272",
            "fax_number": "320-251-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014599",
            "telephone_number": "320-253-0272",
            "fax_number": "320-251-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MN PEDIATRIC DENTISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "STEIL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "320-253-0272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D7765",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D12885",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D11073",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D11344",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.